Dr Mansoor Ali.
The most important basic requirement for getting a better result in spinal disorders is that case taking should be perfect. If you neglect making careful examinations, the patient will be the first sufferer, and then you also suffer from it and ultimately homoeopathy also.
We are going to discuss a methodology, the methodology that everybody can follow with ease with which we can improve our practice with very high success rate with limited failures.
A case of IVDP
Female 35 Years IP No.202 DOA : 28.09.06
- Pain in lumbosacral region – < since 2 months
- < walking, standing
- > lying on sides
HPC : Complaints started 4 years back as pain in lumbosacral region on turning in bed. Took allopathic treatment with transient relief.
Numbness appeared in lower limbs, no touch sensation, no desire for stool.
Diagnosed as IVDP at L4-L5 and L5-S1 and advised surgery
R/C tonsillitis, UTI and Chicken Pox
- Desire to be alone
- Irritability during pain
- Angered easily
- Chilly pt ,bathing in warm water
- Appetite decreased
- Easy satiety
- Desire chillies, pickles
- Hard insufficient stool
- Offensive perspiration
- Dreams of falling from height
- HA from exposure to sun, eyestrain, crowd
- Emptiness not > eating
- Cramps from cold
- White coated tongue
|Pain back < Walking< motion< standing< lying on back||++++|
|Gets angered easily||+||+||+|
|Irritability on pain||+||+|
|Desire to be alone||+|
|Appetite less,easy satiety||+|
|Hard insufficient stool||+|
|HA < Sun exposure to||+|
|Emptiness not > eating||+|
If you are doing a miasmatic cleavage like this, you can find out the dominant miasm and also the correct antimiasmatic remedy.
Physical Examination :
- SLR +ve below 40 on both sides
- PSLR +ve below 40 on both sides
- Gaenslen’s test –ve
- X-ray :Space reduction b/n L4 & L5, L5& S1
- MRI osterior & postero lateral disc prolapse at L4-L5 causing thecal sac & L5 root compression.Posterior disc bulge at L5-S1 with minimal thecal compression.Spinal canal stenosis at L5
Repertorial Totality :
- Mind. Company aversion to
- Stomach. Appetite easy satiety
- Stomach. Desire pungent things
- Sleep. Dreams falling from high places
- Perspiration. Odor offensive
- Stomach. Emptiness eating not >
- Head. Pain. Sun from exposure to
- Back. Pain Walking while
- Back. Pain Standing while
We had not considered lack of desire for stool, urinary complaints ect. Since these are the common symptoms of IVDP
- Sulphur 16/7
- Sepia 14/7
- Lyco 13/6
- Thuja 13/6
- Phos 12/7
- Gets angered easily
- Cramps from cold
- Chilly patient
Basis of selection
Offensive perspiration,mental picture of the patient and particular modality pointed to Sepia
|05.10.06||Can walk with less pain,other symptoms persist||SL|
|12.10.06||Can walk but with pain||Sepia 1M|
|26.01.07||< of pain||Sepia 1M|
|24.03.07||Pain if walked and exerted much||SL|
- Pain is not relieved within a week. After two week she could walk, but with pain,intensity rezuced after Sepia 1M.
- After 1 month she could stand without pain.
- After 6 months pain comes only if walked for a long distance and if she exerted much.
- We had verified in several patients in our OPD & IPD that – higher potencies yield much better results in both acute and chronic spinal disorders.
IVDP- Related rubrics
We have to consider the following rubrics in addition to the mental generals and physical generals of the patient to get a better result.
1.Back pain: Cervical region
We have to select specific location where actually the pain is, then we will get the correct remedy which have specific action on that location
2.Sciatica : Extr. Pain.Lower limb. Sciatica
3.Stiffness : Back. Stiffness- Cervical
Nape of neck
4.Numbness : Back. Numbness.
5.Weakness : Back. Weakness
6.Paralysis : Extr. Paralysis
Prescribing on Etiology offers excellent results
If the cause is removed effect goes off by themselves
- Cervical pain over lifting from : Calc.c
- From false position in sleep : Rhus.tox
- Back Pain after LSCS : Hypericum
- Fall on Coccyx : Hyper, Silicia, Sitting <: Kali.bich
- Lumbago after injury : Agaricus
- Fall on sacral region : Kali.C
- Acute Management and Chronic Management
- We have to give immediate relief to the pain in sciatica
Give importance to
Side : Right : Coloc, Lach, Lyc, Gnaph
Left : Phos, Spigelia
Modality : Flexing limb < : Colocynth
Standing <, motion > etc
Concomitance : Accompanied by….
Haemerrhoids : Aesc
Numbness with : Gnaph
Aetilogy : Injuries after : Arn, Hyper, Ruta (We got much result from Hypericum higher potency than other remedies)
Therapeutics in sciatica: We found the following remedied highly useful, but never limit your prescription to these remedies)
Sciatica on both side : Chamomilla mother tincture offers immediate relief to pain
Deformed vertebra : Calc.Phos
Parts cold to touch, periodicity : Ars.alb
Lumbago + Sciatica : Rhus.tox- It is the best remedy for a combination of lumbago and sciatica. Sciatica arising from over-exposure to wet or from lifting, wrenching and over-exertion. Great relief from warmth.
Sitting <,Walking>,Lying down OK : Amm.m
Pain < by sitting & standing: Valeriana
Pain from buttock to ankle, least movement aggravates, with perspiration, lying on painful side > : Bry
Murphy’s Repertory : Readers are requested to read carefully the following chapters in Murphy’s repertory that contain so many useful rubrics for our day to day practice.
- Emergency : Back. Injuries after
- Leg : Sciatica
A Case Cervical Spondylosis
- Male 50 years admitted in our IPD
- Pain in neck with stiffness, can’t turn to left ,<jar++,moving,yawning
- >Warm bathing,lying on sides
- Fish selling in bicycle, stopped since 6 months
- Concomitant : Numbness of palms, weakness of hands
- Extension : Shoulder, chest,dorsal region
Repertorial Totality :
- Mind. Contradiction Intolerant of
- Gen.F&D. Sweets desire
- Sleep.Sleeplessness noise from
- Mouth. Cracked tongue
- Ext.throat. Torticollis
- Back.Pain. Cervical region moving on
- Back.Stiffness. Cervical region
- Extr. Numbness hand
- Phos. 15/7
- Lyc. 15/6
- Sulphur. 14/8
- Nux. 13/9
- Calc. 10/6
- Renal calculi
- Cervical region
- Warm bathing >
- Lying head high <
Prescription : Lyc. 200/
Lyc 200 prescribed – not much improvement for pain within one week
So we prescribed Lycopodium 1M – with in next one week much relief to pain
Then prescribed and raised the potency infrequently at longer intervals- since Lycopdium is a long acting remedy – If we are repeating Lycopodium and Phosphorous like remedies in chronic cases frequently that may spoil the entire case – so called as double edged swords.
This case we got immense relief within 2 months and now he is again ding his fish selling in bicycle.
Important remedies for cervical spondylosis verified in our college
Cimicifuga : Most suitable for IT professionals & stenos with stiffness & pain in neck
Nux.v : Sedentary, constipation, alcohol,burning spine, turning difficult
Lachananthes : Torticollis with severe muscle spasm, numbness- specific action- acute remedy
Calc.carb : Most successful remedy in several cases with rigidity & stiffness in morning, turning difficult and tendency to strain easily
Kalmia : Rt. Ext. down, with numbness, C5-C7
Rhus.tox : Pain from false position,<sitting, exertion,> warmth application
Lycopodium : Pain + Urinary + GIT Acute : Berberis .v mother tincture
Rubrics to be considered in cervical spondylosis
Give importance to
• Side Right : Sang, Kalmia
Left : Conium
Looking up < : Graph
Stooping < : Rhus.t
Coughing on : Sulphur
Turning < : Agaricus, Aesc, Bry, Sulph etc.
Extension : Consider this also
Look for the associated complaints like
- Blurring of vision and select additional rubrics
Role of Physiotherapy in Homoeopathy
We are doing physiotherapy in the following conditions in our college
- Pain- all types
- Nerve Injury
- Muscle weakness
- Post traumatic cases
- Soft tissue injury
- OA Knee
- Gynaecological pain
- Cx & Lumbar spondylosis
- Frozen shoulder
- Bell’s palsy
- Tennis elbow
- Plantar fasciitis
- Muscle spasm/cramps
Local applications not good ?
It is not useful, either in acute local diseases of recent origin or in local affections that have already a long time, to rub in or apply externally to the spot an external remedy, even though it be the specific homoeopathicity, even although it should be at the same time administered internally; for the acute topical affections , which have not been caused by external injury of proportionate violence, but by dynamic or internal causes….
Internal & External together- not good
…… the simultaneous local application, along with the internal employment, of the remedy in diseases whose chief symptom is a constant local affection, has this great disadvantage, that, by such a topical application, this chief symptom (local affection) will usually be annihilated sooner than the internal disease, …….. a perfect cure; or at least it will be difficult, and in some cases impossible.
Reduction,bandage,local application- Good in
Those so-called local maladies which have been produced a short time previously, solely by an external lesion, ….. the whole living organism sympathizes . The treatment of such diseases is relegated to surgery; but this is right only in so far as the affected parts require mechanical aid, ….. by the reduction of dislocations, by bandages, by the extraction of foreign bodies etc…. then the services of the dynamic physician and his helpful homoeopathy come into requisition.
- Never apply local heat or oils to relive pain- really worse for the patient
- But good in stiffness & paralysis (Homeopathic materia medica- Kalmia)
- Salt application- to relieve pain, weakness of muscles & nerves
- May prevent deformities (Natrum family- Clinical materia medica)
Remember : The accessory management or accessory life saving measures are not the monopoly of any of the medical system. Try to incorporate it in your practice, which offers faster and better results.
- Homeopathy offers effective treatment for Neurospinal disorders
- Detailed case taking and proper repertorisation are essential
- Aetiological prescription offers immediate relief
- Higher potencies are useful both in acute & chronic
- Homeopathic remedies along with accessory mgt offers excellent, speedy recovery
- It is better to avoid external applications to relive pain
This is only a methodology. Study the subject in detail. Homoeopaths should see opportunity in every difficulty… but not difficulty in every opportunity. We must have good vision, loyalty and dedication. Take homoeopathy in to greater heights.
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